PUSH Post
Public United for Savings in Healthcare
8 - 14 December 2008
Happiness is very much in the
news this week. A widely quoted
study shows that happiness is
contagious and extends its benefits
well beyond what we expect: as
much as two to three degrees of
separation. Add a handful of nuts
to your diet and you will reap
significant benefits for your heart
and circulation, provided too that
you stick to the other elements of a
"Mediterranean" diet. Sadness, is
not depression; yet, the relentless
forces of medicalization have
roped a normal life event into the
list of psychological problems that
need treatment. A vaccine for
malaria is on the horizon. It has
been successfully field tested in
Africa. The wide range of
chemicals that are added to the
environment is making the male
sex more feminine, man and beast.
It appears that computers take
better histories from patients than
doctors and are less likely to miss
important details. And lastly,
watch out when you surf the Web
for your health problems: the
quality of content can be very
uneven. Non-profit and
professional society sites are more
reliable than commercial offerings.
Experience makes us see an
enormous difference between piety
and goodness.
Blaise Pascal, philosopher and
mathematician (1623-1662)
Is there an epidemic of
depression?
Men are the weaker sex
Computers outdo docs
A vaccine for malaria
All Websites are not equal
Much more at:
Happiness is contagious spouse's mood. Your happiness depends
not just on your choices and actions, but
also on the choices and actions of people
you don't even know who are one, two
W-Wellness and three degrees removed from you.
These results are even more remarkable
Positive psychology - the discipline that considering that happiness requires close
studies the bright side of our minds rather physical proximity to spread and that the
than the diseased - has been very much in effect decays over time: just like any
the news in recent years. Happiness is not common contagion.
something that happens to you, but is
something that you can seek. Conclusion:
"Human happiness
A study published this week in the British is not merely the
Medical Journal (BMJ) has been making a province of isolated
sensation. The study that followed a large individuals. ...
group of 4700 people for 20 years seems People's happiness
to show that happiness is more contagious depends on the happiness of others with
than previously thought. The authors state whom they are connected. ... The better
that how happy you are may depend on connected are one's friends and family, the
how happy your friends' friends' friends more likely one will attain happiness in the
are, even if you don't know them at all. future. ... This provides further
And a cheery next-door neighbor has more justification for seeing happiness, like
effect on your happiness than your health, as a collective phenomenon."
Nuts-14; olive oil-7
S-Syndrome X - the metabolic syndrome
The metabolic syndrome is the collective
name applied to a common combination of
health risks - high blood pressure, diabetes,
obesity and abnormal lipid (cholesterol)
profile - that increase the likelihood of
cardiovascular problems like heart attack
and stroke. Life style changes are the key to
control of the disease. The Mediterranean
diet - a diet rich in fruit, vegetables and
fish, and based on olive oil - has been
shown to have a protective effect on
individuals at risk.
Spanish researchers found that adding nuts
worked better than boosting the olive oil in a typical Mediterranean diet. Both regimens
cut the heart risks in more people than a low-fat diet did. What's most surprising is that
they found substantial metabolic benefits in the absence of calorie reduction or weight
loss. The people who improved most were told to eat about three whole walnuts, seven
or eight whole hazelnuts and seven or eight whole almonds.
The researchers say that nuts could have an effect on metabolic syndrome by multiple
mechanisms. Nuts are rich in anti-inflammatory substances, and antioxidants, such as
vitamin E. They are high in unsaturated fat, a healthier fat known to lower blood
triglycerides and increase good (HDL) cholesterol. Dietitians advised the two groups on
the Mediterranean diet to use olive oil for cooking; increase fruit, vegetable and fish
consumption; eat white meat instead of beef or processed meat; and prepare homemade
tomato sauce with garlic, onions and herbs. Drinkers were told to stick with red wine.
CAUTIONARY NOTE: Salas-Salvado and another co-author disclosed in the publication
that they are unpaid advisers to nut industry groups. Salas-Salvado said all of their
research "has been conducted under standard ethical and scientific rules" and that peer-
review journal editors determined the study results were not influenced by food
industry ties.
© Dr Arjun Rajagopalan
8 - 14 December 2008

Men are the weaker

sex
Y-Yesterday, today and tomorrow
The male gender is in danger. A
host of common chemicals is
feminising males of every class,
from fish to mammals, including
humans. A report, published by
the charity CHEMTrust, drawing
on more than 250 scientific studies
from around the world, concludes:
"Males of species from each of the
main classes of vertebrate animals
(including bony fish, amphibians,
reptiles, birds and mammals) have
been affected by chemicals in the
environment."
• Communities heavily polluted
with "gender-benders" have given
birth to twice as many girls than
boys. Normally 106 boys are born
for every 100 girls, but the ratio is
slipping.
• New research shows that baby
boys born to women exposed to
widespread chemicals in
pregnancy are born with smaller
penises and feminised genitals.
• Sperm counts are dropping
precipitously. Studies in more
than 20 countries have shown that
they have dropped from 150
million per millilitre of sperm
fluid to 60 million over 50 years.
One of the world's foremost
authorities on gender-bender
chemicals, has stated: "We have
thrown 100, 000 chemicals against
a finely balanced hormone system,
so it's not surprising that we are
seeing some serious results."
The medicalization of sadness
F-Fads sadness. Intense sadness should be
sensitive to social context. It not only
"...despite widespread beliefs to the arises but also persists as a function of a
contrary, the rate of depressive disorders situation of loss. When the situation
in the population has not undergone a improves, the sadness should dissipate.
general upsurge. ... What has changed is In contrast, depression is relatively
the growing number of people who seek impervious to such positive changes.
treatment for this condition, the increase
in prescriptions for antidepressant There are a variety of psychotherapies
medications, the number of articles about that are as effective as medication in
depression in the media and scientific treating depression, with the exception of
literature, and the growing presence of the most severe cases. Cognitive-
depression as a phenomenon in popular behavioral therapy looks at how an
culture." individual's negative thinking is biasing
their interpretation of environmental
The problem seems to have arisen from events and influencing mood.
psychiatry and the other mental health Interpersonal therapy has the individual
professions using a definition of work intensively on addressing the most
depression that combines important relationship issues
genuine depressive disorder that are a source of
with intense, but normal, depression. Behavioral
states of sadness. Stretching activation has the individual
the boundaries of disease to systematically act to change
include states that occur in the circumstances that are
normal life situations is a causing sadness. These
common device that is called therapies are based on
medicalization. Depression has principles that individuals
not been exempt; what we are now might apply to themselves even without
seeing is the medicalization of sadness. the help of a therapist, and all involve
acting to change one's relationship to the
There are some differences that can be environmental factors that are causing
used to separate depression from the distress.
Q-Quality in health care
The medical history Medical history is acknowledged as the sine qua
non for quality medical care. Recognizing problems
is pre-requisite for managing them. Medical
histories, typically, are incomplete and inaccurate. Computers are a solution to this issue of
information gathering about patients. In a recent study from admissions to a large hospital
in Germany, histories were acquired by physicians in the usual way and by a computer
program interacting directly with patients. Decision-making of what medical issues were
queried by computer were made internally by the software. Physician-acquired and
computer-acquired histories were compared on a patient-by-patient basis.
The computer histories reported 160 problems not recorded in physician histories or slightly
more than 3.5 problems per patient. The data showed that the problems detected by
computer but not physician histories were both acute and chronic and that the computer
histories detected a significant number of issues important for preventing further morbidity.

A vaccine for malaria at last

Y-Yesterday, today and tomorrow
247 million malaria cases occur worldwide causing almost 1 million
deaths per year. Malaria has always been a hard scourge to control. The
parasite that causes it is tough and versatile, and the pest that delivers
it, the mosquito, is everywhere. Two breakthrough papers published
early this week in the New England Journal of Medicine report the
success of a pair of new vaccines tested in groups of children in Africa.
In one study, the vaccine was developed by Glaxo SmithKline and
bankrolled in part by the Malaria Vaccine Initiative, under a grant from
the Bill & Melinda Gates Foundation. The group that received the
vaccine had a 53% lower infection rate than the control group, and the
effect lasted for up to eight months. Reassuringly, the vaccine did not
get in the way of others. The disease is not beaten yet but along with
other initiatives that are stepping up the push to deliver pesticides and
mosquito-resistant bed nets across Africa, it could very well be on the
run at last.
I-Internet
Patients seek medical information through a search engine
rather than directly accessing a specific Web site.
Unsponsored and professional society Web sites provide
significantly higher quality information about common
elective surgical procedures compared with commercially
sponsored Web sites.
A panel of surgeons evaluated 145 Web sites using a
validated, qualitative rating system. Analyses showed
unsponsored sites had higher quality scores, than sites
sponsored by commercial organizations and representing
advertisements. Searches performed with a technical
search term had significantly higher mean composite
scores than searches using a layperson term.

© Dr Arjun Rajagopalan